Complete staghorn stone removal can pose a challenge to the endourologist. We describe a robotic approach for complete removal of a recurrent staghorn stone after a previous open pyelolithotomy. The patient is placed in a left modified flank position with mild flexion. 4 ports were placed: 12mm left paramedian camera port, 8mm left lower quadrant robotic port at the level of the umbilicus, 8mm midclavicular robotic port 2 finger breaths below the costal margin, 12mm infraumbilical paramedian Airseal assistant port. The white line of Toldt was incised to mobilize the colon medially. Anterior Gerota's fascia was opened and tacked to the lateral abdominal wall exposing the renal pelvis and parenchyma. An intraoperative ultrasound confirmed the underlying stone. A V-shaped Gil-Vernet pyelolithotomy incision was made over the renal pelvis and extended into the superior and inferior caliceal infundibula. Prograsp forceps were used to manipulate the stone out of the renal pelvis. Pressure was held on the renal pelvis with mini-laps for hemostasis. The collecting system was inspected and irrigated using the robotic lens. The pyelotomy was closed with 4-0 Monocryl suture on a TF needle in 2 lengths of suture. The sutures were tied in tension-free watertight mucosal-to-mucosal apposition fashion. Gerota's fascia was closed over the renal pelvis and the kidney was re-retroperitonealized by tacking the colon to the white line of Toldt. The specimen was retrieved through a mini-Pfannenstiel incision via a specimen bag. Flexible cystoscopy was then performed for retrograde pyelogram and insertion of a double J stent.